Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states ...Read More
There is a paradox in the question, “Is alcoholism a disease? Alcoholics Anonymous asserts that alcohol abuse is an illness or disease, cannot be cured and can only be controlled through abstinence and with the help of AA and in belief in a higher authority. The medical establishment tends to view alcohol abuse as a disease that might be cured if the right set of medications can be found. Recently, there is evidence that drugs, such as Naltrexone, Acomprosate and Disulfiram help break the cycle of alcohol addiction. Yet, both AA and the Betty Ford Clinic are opposed to medication. That is part of the paradox. If alcoholism is a disease, why not use medication.
Where is the paradox in all of this? At least some people who are anti AA also reject the idea the alcoholism is a disease. Oddly, that puts them on the same side as AA in rejecting the use of medications.
All the evidence is that alcohol abuse is a disease. However, rather than being one disease, it is many. Just as there are more than one type of cancer, there are more than one type of alcohol addiction and that is why neither one medication nor one type of treatment will fit everyone. For some people, alcohol abuse results from their genetic background while for others it can result from PTSD as a result of either war or having been involved in some other catastropic event. For others, the problem lies elsewhere.
Therefore, the medications being used for alcohol addiction do not help everyone. In fact, there is a small but significant percentage of people who are cured by the combination of medication and psychotherapy while others are not. It is anticipated that, in the next ten years the percentages will increase and the scientific mental health community will be able to speak of a cure. That will mean the different medications or combinations of medications and therapy will be used to bring about a cure.
The fact is that, despite all of their efforts, including attendance at AA meetings or the Betty Ford Clinic, there are many people who relapse from addictions regardless of all their efforts to be abstinent. In my thinking, these people are not failures. Instead, they are suffering from a terrible disease.
What are your opinions about this issue?
Allan N. Schwartz, PhD